How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,349 to $8,128Professionalmedian $1,479 · 10th to 90th $372 to $1,950
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,621.81 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,621.81 | $1,698.24 | $1,698.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $6,918.31 | Facility | None | $3,981.07 | $3,981.07 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $269.15 Median $977.24 Typical High $2,344.23 | Professional | None | $269.15 | $977.24 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $3,162.28 | Professional | None | $977.24 | $1,412.54 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,344.23 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,344.23 | $3,311.31 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,621.81 | $1,778.28 |
Priority Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,454.71 | Professional | None | $977.24 | $1,412.54 | $2,454.71 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,951.21 Typical High $10,471.29 | Facility | None | $891.25 | $2,951.21 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,412.54 | $1,584.89 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,122.02 |
Where Michigan sits
The same service costs 5.5 times more in Colorado than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $14,842WV $2,709
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.